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Evaluation of the creatinine-based chronic kidney disease in children (under 25 years) equation in healthy children and adolescents

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Abstract

Background

The Chronic Kidney Disease in children (CKiD) equation to estimate glomerular filtration rate eGFR = k × Ht / SCr (Ht = height in cm, SCr = serum creatinine in mg/dL), with fixed k = 0.413, has recently been optimized by introducing age/sex dependent k-values valid for young children up to young adults (the CKiD Under 25 years (CKiDU25) equation). Although the CKiD equation was designed for children with chronic kidney disease (CKD), this equation found common use both clinically and in research, and also in children without CKD. This report aims to evaluate properties of CKiD and CKiDU25 in healthy children and adolescents.

Method

Sex-specific metadata (height and creatinine) for healthy children were obtained from national growth curves and creatinine versus age curves. These data were used to calculate average CKiD and CKiDU25 values for each year of age and compare them against age-independent measured GFR of 107 mL/min/1.73 m2.

Results

The CKiD estimations show a steep decline with age (1.5 mL/min/1.73 m2/year in females and 2.0 mL/min/1.73 m2/year in males) over the entire age range (2–20 years) and large differences between adolescent males and females. Due to the age/sex specific k-values, the CKiDU25 equation solves this age-decline artifact of the CKiD equation. However, CKiDU25 still shows a systematic higher estimation of about 10% in healthy males compared to females over the entire age range.

Conclusion

Although the CKiDU25 shows major improvements compared to the CKiD equation, as the unexpected age decline has been removed, a systematic difference is still observed between healthy males and females.

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Author information

Authors and Affiliations

  1. Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Etienne Sabbelaan 53, 8500, Kortrijk, Belgium

    Hans Pottel

  2. Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden

    Jonas Björk

  3. Clinical Studies Sweden, Skåne University Hospital, Forum South, Lund, Sweden

    Jonas Björk

  4. Department of Nephrology-Dialysis-Transplantation, University of Liège (ULiège), CHU Sart Tilman, Liège, Belgium

    Pierre Delanaye

  5. Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France

    Pierre Delanaye

  6. Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden

    Ulf Nyman

Authors
  1. Hans Pottel
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  2. Jonas Björk
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  3. Pierre Delanaye
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  4. Ulf Nyman
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Contributions

HP made the calculations and wrote the first draft. All co-authors made comments and suggestions to improve the report. All authors have read and approved the final version.

Corresponding author

Correspondence to Hans Pottel.

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The authors declare no competing interests.

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Hans Pottel, Jonas Björk, Pierre Delanaye, and Ulf Nyman are members of the European Kidney Function Consortium.

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Pottel, H., Björk, J., Delanaye, P. et al. Evaluation of the creatinine-based chronic kidney disease in children (under 25 years) equation in healthy children and adolescents. Pediatr Nephrol 37, 2213–2216 (2022). https://doi.org/10.1007/s00467-022-05429-0

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  • DOI: https://doi.org/10.1007/s00467-022-05429-0

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